Utility of Single Phase CT in Identifying Parathyroid Adenomas - A Feasibility Study

Publication date: Available online 17 May 2017
Source:Current Problems in Diagnostic Radiology
Author(s): Ethan Silver, Nader Sadeghi, Stanley Knoll, M. Reza Taheri
ObjectiveWe tested the hypothesis that a single-phase neck CT is not inferior to multiphase neck CT (MPNCT), ultrasound or nuclear medicine sestamibi scan in identifying parathyroid adenomas (PA).Methods29 patients who had a MPNCT for the evaluation of a PA were identified. 11 patients met the inclusion criteria. During the 30 second arterial phase CT (APNCT), a normalized Hounsfield unit (NHU) of suspected PA was compared to NHU of a normal appearing level I and a level II lymph node. A PA was defined as a lesion with a ratio of greater than 1.4 when compared to the level I and level II lymph node. This cut off was determined based on the normalized ratios between level II and level I lymph nodes. Results of intra-operative PTH assays and surgical pathology were used to validate the accuracy of this technique.ResultsThe sensitivity of this method in APNCT is 90.9% while positive predictive value is 100%. The sensitivity / positive predictive value of ultrasound and nuclear medicine are 60%/100% and 90%/100%, respectively.ConclusionThe sensitivity of APNCT is equivalent to that of MPNCT in identifying PA.



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